Captive Funded Risk Reduction

Captive Funded Risk ReductionMedical Center of Central GeorgiaStaff Injury Prevention Program

Medical Center of Central GA637 Bed Not for Profit Community HospitalLevel 1 TraumaWomen's Services 3000+ BirthsChildrens Hospital 314,000 Annual Visits25,000 OR Visits5000 EmployeesBacon Belt of America!

The BeginningSafety Committee meets monthlyReview of injuries showed frequent patient handling occurrencesThe injuries were NOT r/t bariatric patients only

LOTS of discussion about how to reduce injuryAnnual training on proper body mechanics?Staff education about how injuries were happeningIncreased utilization of Lift Team?

Staff Injury Prevention InitiativeNurses lift 1.8 tons during shiftHospital injuries 8.8/100 FTEsNurses who suffer injuries on the job are much more likely to leave nursing and patient careInitiative to protect staffBased on evidenced based researchEquipment must be available for staffEquipment must be usedAdministration support

Staff Injury Prevention InitiativeJCAHO - 8 standards relate SIPANA Handle with CareOSHAMagnet FOM 4.2 - Safe Environment 6.6; 6.7; 6.10; 6.21 Safety InitiativesNational legislation in many states

SIP/MLPReview of best practices:Culture change was neededStaff Injury Prevention Program/Minimal LiftTakes focus off Bariatrics Focus on Lifting, Moving, TransferEquipment makes a differenceExpert Partner neededWe needed Fund$ to accomplish

Staff Injury Prevention Initiative Prevention Initiative Case

Our People Minimal Lift Program geared toward staffService Excellence- Improve Customer ServiceSafety Decrease employee injury Financial GrowthAverage annual spend R/T Back Injury $400-500,000Missed workClear Opportunity to save money and make a difference

The CASE for Change

Workman comp payouts of $400-500,000/ year

Lost Days to Injury either out of work or light duty

Risk Management department was integrated into the Finance Department in 2008- (member of Safety Committee)

AVP Finance proposed CAPTIVE as Funding possibility to help decrease Workmans Comp Liability by decreasing staff injury

What IS a CAPTIVE? In Simple Terms a Captive is an INSURANCE COMPANY - Insured is the owner of the company

We started our CAPTIVE in 1994 and had very good success in the stock market

We had in EXCESS of 30 million shares

Possibility Dividend the funds / vs Grant Program

Captive/ Grant Opportunity

GRANT$ Could we design a program to fund initiatives that would help with professional indemnity

and reduce $$$$$$$Claims Cost?$$$$

Captive Funded GrantReducing Claims CostDecreases the amount to fund

Funding = Paying Premiums

First StepsTrack issues to determine how to reduce claimsSafety Committee already looking at Patient Handling Identified Patient handling injury as an opportunity

Captive/ Grant ProposalCaptive would fund certain initiatives Application process Proposals would have to: Encourage risk management/reduction Provide staff education Demonstrate closed loop report back to show return on inve$tment DecisionGrant out 10-15% of audited net incomeAllocated Income from prior year

The Partnership BeginsDiligent Process:Conference CallAssignment of RolesProcess MappingEducationOrg Wide Administration and Department HeadsImplementation

Nursing and Patient Care education Critical to success of programEducation and Accountability

Minimal Lift ProgramAssessmentImplementationEvaluationWhat equipment is neededWhere will equipment be locatedWhat is staffs current knowledgeHow will we educate

The MCCG/Diligent Partnership

The Diligent/MCCG partnership began with the contract signing on Oct 22nd, 2008. It included 928 contract hours time, which includes 360 hours during implementation and 400 hours over 36 months for clinical support as well as phone/meeting time. As of July 1st, 2010, MCCG has received 704 hours and has 224 hours left in the contract. Training was completed for 1600 general staff, 150 coaches and 11 rehab coaches.

AssessmentRecommendations were provided by Diligent for best locations on each unitAll floors had the ability to store their equipment but needed some spring cleaning done.Shelving vs. hooksOutlets for chargingAccessibility is KEY

Location Location - Location

Easy Accessibility

Centrally Located garage

Centrally Located garage

Plan for Battery Charging

Implementation Safe Patient Handling at MCCGCulture ChangeResearch Surveyed staff to assess knowledgeManager Buy-in Leadership roundingAccountability

Staff buy-inAwarenessRationaleEducation

TMC classes 8 hoursGeneral Staff classes 2 hoursContest to NAME program

Establish PAR Levels

PAR Supplies (near at hand)

Proactive use of Supplies

SPH Minimal Lift - LiftsaverNursing units assigned TMCs days & nightsEMERGENCY CENTERSurgical ServicesLabor and DeliveryCath & Vascular Labs

Support Departments have TMCsX-RAYRehabHome HealthMorgue!!

Strategic Placement - CT

Liftsaver Ceiling Lift Placement

Liftsaver Ceiling Lift Placement

Critical Care ConcernsHAPU r/t loss of air flowWe will never use this stuffIt will take too longI know how to move MY patient

Repositioning - good use of resources

Repositioning Benefits

Changes Decreased calls to Lift TeamStaff can turn, reposition and move patientsEquipment changes resources needed from 3 or more to 1!!Leadership rounding/Unit SurveysContinual assessment of staff knowledgeStaff held accountable to policyEVERY injury investigated immediately

SAFETY

Lift from Floor to Chair

Safety

Easy on Patient and Staff

Easy

Easy

Back To Bed

Good-by Rollerboards

Liftsaver Program

Diligent Activity Report (sample) We met with OR and with Critical Care. The computerized assessment profile was reviewed and discussed. Patti has done a great job on this. Specialty training sessions will be scheduled for OR, rehab,PACU, ED, CATH, Radiology and same day surgery. More days may be needed for some units and this will be determined later on. Process Resolution is scheduled for March 24th 8-2, and the meeting with the executive team on March 25th at 11:30 AM.We look forward to working with all involved at MCCG.

Evaluation/ResultsThe Diligent/MCCG partnership began with the contract signing on Oct 22nd, 2008.

Included 928 contract hours time 360 hours during implementation 400 hours over 36 months for clinical support as well as phone/meeting time. As of July 1st, 2010, MCCG has received 704 hours and has 224 hours left in the contract. Training was completed for 1600 general staff, 150 coaches and 11 rehab coaches.

Evaluation/Results/Statistics The pre-program baseline number of patient-handling injuries developed was agreed upon as 82 injuries.

The Diligent program went live on 7/2/09 on the designated areas agreed upon.

Since 9/2/09 there has been a total of 1 recordable injury and 8 incidents (3 repositioning in bed, 4 other and one from floor).

Evaluation/ResultsTherefore, the overall decrease in injuries was 98.7%.

The recordable injury did not meet the Diligent contract criteria and is exempt from the reimbursement guarantee.

Evaluation/ Results

8 Number of Injuries that potentially could have been avoided through the use of ARJO-Huntleigh equipment

If equipment had been used, the injury reduction would have been 100%.

CURRENT STATUS

The Diligent/MCCG Lift Saver program has created an overall awareness in the facility and highlighted the importance of staff to effectively plan for patient These results are a very good start and the nursing management and staff should be commended. Our goal is to continue the success for the rest of the contract.

CURRENT STATUS

The overall 98.7% decrease in staff injuries from the start of the program in 10 months is indicative of the beginning of a cultural shift towards a safe patient handling environment. MCCG has started using score cards monthly to be accountable for the Lift Saver program. The results have been very promising for March through June, with units scoring above 86% on average.

CURRENT STATUSMCCG has started using score cards monthly to be accountable for the Lift Saver program. The results have been very promising for March through June, with units scoring above 86% on average.